Efficacy of low-dose human chorionic gonadotropin alone to complete controlled ovarian stimulation.

Filicori M, Cognigni GE, Gamberini E, Parmegiani L, Troilo E, Roset B.

Source

Reproductive Endocrinology Center, University of Bologna, Bologna, Italy. marco.filicori@unibo.it

Abstract

OBJECTIVE:

To prove that low-dose hCG alone can be clinically used to replace FSH-containing gonadotropins to complete controlled ovarian hyperstimulation (COH).

DESIGN:

Controlled, prospective, randomized study.

SETTING:

Academic center.

PATIENT(S):

Infertile patients who are candidates for assisted reproduction.

INTERVENTION(S):

Patients received [1] recombinant FSH or hMG throughout COH (group A); [2] ovarian priming with recombinant FSH/hMG followed by low-dose hCG (200 IU/day) alone (group B).

MAIN OUTCOME MEASURE(S):

Medication consumption; daily serum and follicular fluid (FF) measurements of LH, FSH, hCG, E2, P, T, and androstenedione (A); number and size of follicles; intracytoplasmic sperm injection (ICSI) outcome.

RESULT(S):

In group B: [1] duration and dose of recombinant FSH/hMG administration were reduced; [2] preovulatory serum hCG, E2, and T were higher, whereas FSH was lower; [3] FF hCG, E2, T levels, and E2/T, E2/A, and E2/P ratios were higher, whereas A was lower; [4] small but not large preovulatory follicles were reduced; [5] fertilization rates were higher; and [6] serum and FF P levels, and ICSI outcome did not differ.

CONCLUSION(S):

Low-dose hCG alone in the late COH stages: [1] reduced recombinant FSH/hMG consumption whereas ICSI outcome was comparable to traditional COH regimens; [2] stimulated follicle growth and maturation independent of FSH administration; [3] was associated with a reduced number of small preovulatory follicles; [4] did not cause premature luteinization; [5] resulted in a more estrogenic intrafollicular environment.

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2013年5月16日

COH晚期單獨使用低劑量hCG並不會造成過早黃體化